高血压脑出血患者血糖波动对微创碎吸术后血清同型半胱氨酸、尿酸水平的影响

Effects of blood glucose fluctuations on levels of serum homocysteine and blood uric acid in patients with hypertensive intracerebral hemorrhage after minimally invasive aspiration

目的 探讨高血压性脑出血(HICH)患者血糖波动对其微创碎吸术后血清同型半胱氨酸(Hcy)、血尿酸(UA)水平的影响。方法 选取2018年1月~2020年10月在本院接受微创碎吸术减压治疗的HICH患者125例进行回顾性研究,根据患者是否存在应激性高血糖症(SHG)分为两组,其中61例存在SHG的患者为SHG组,不存在SHG的64例患者为对照组,对比两组患者术后相关参数。结果 两组患者的一般资料比较无统计学差异(均P>0.05),SHG组患者术前血糖高于对照组(P<0.05);SHG组患者住院时间和抗生素应用时间均长于对照组(P<0.05),术前血肿量大于对照组(P<0.05),术后肺炎发生率、6个月死亡率高于对照组(P<0.05),两组患者手术时间、术后再次出血、颅内感染发生率无统计学差异(P>0.05);术后1、3 d的Hcy、UA浓度高于对照组(P<0.05)。结论 高血压性脑出血患者术前存在应激性高血糖症时,其术后预后较差、恢复时间较长,并发症发生率也高于血糖正常者,血清Hcy、UA浓度在短时间内较高,应密切观察患者围术期血清指标,以预测患者病情变化趋势,及时采取预防措施。

Objective To explore the effects of blood glucose fluctuations on levels of serum homocysteine(Hcy)and blood uric acid(UA)in patients with hypertensive intracerebral hemorrhage(HICH)after minimally invasive aspiration.Methods A retrospective study was performed on the 125 patients with HICH undergoing minimally invasive aspiration in the hospital between January 2018 and October 2020.According to presence or absence of stress hyperglycemia(SHG),they were divided into SHG group(61 cases)and control group(64 cases).Postoperative related parameters between the two groups were compared.Results There was no significant difference in the general data between the two groups(P>0.05).The preoperative blood glucose in SHG group was higher than that in control group(P<0.05).The hospitalization time and usage time of antibiotics in SHG group were longer than those in control group(P<0.05),preoperative hematoma volume was greater than that in control group(P<0.05),incidence of postoperative pneumonia and mortality within 6 months were higher than those in control group(P<0.05).There was no significant difference in operation time,incidence of postoperative re-bleeding and intracranial infection between the two groups(P>0.05).The levels of Hcy and UA in SHG group were higher than those in control group at 1d and 3d after surgery(P<0.05).Conclusion The postoperative prognosis is worse,recovery time is longer and incidence of complications is higher in HICH patients with SHG than those with normal blood glucose.The levels of serum Hcy and UA are relatively higher in a short time.The perioperative serum indexes should be closely observed to predict change trends of patients’conditions and take timely preventive measures.